Methods: Electronic records for patients seen in the UH ED from October 1st 2014 to February 28th2015 were obtained. Information was collected on age, gender, ED diagnosis, triage time, and HIV testing. Individual patients, visits, and patients who were tested for HIV were electronically identified. Random sampling of 500 patients was performed to identify those eligible for screening. Univariate analysis was done to assess the screening characteristics of patients by age, gender, time of day, and diagnosis.
Results: Only an estimated 9% (1,711/18,983) of patients eligible for screened were screened in the ED. Screening rates among eligible patients by age were as follows: 16% (18-25 yrs), 12% (26-35yrs) and 8% (35-45yrs). Overall 7.7% of eligible males and 10.2% of eligible females were screened. 19.6% (19 – 20.1) of eligible patients in fast track were screened versus 1.7% (1.6 - 1.8) in the main ED. 85% of patients screened were triaged between 6AM and 8PM with 90% of all screening tests done by the HIV counseling testing, and referral service. Individuals with a diagnosis suggestive of increased risk of HIV infection, i.e. patients with an ED diagnosis of screen for venereal disease, venereal disease contact, and screening for unspecific chlamydial diseases, were screened for HIV 41%, 36%, and 28% of the time respectively.
Conclusion: Despite a high background prevalence of HIV only a small fraction of patients were screened in the ED for HIV. Due to the high prevalence of HIV in our urban cities, ED plays an integral public health role in the early identification and linkage to care of patients with HIV. By evaluating our current screening process we can identify opportunities for improvement in HIV testing and linkage to care.
S. Swaminathan, None
D. Cennimo, None
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